The Therapeutic Relationship between Clients - Assignment Example

Reaction Paper Name: Unit: Course: Supervisor: Date of submission: Question 1 (A) Therapeutic relationship should be characterised by the following: (a) Trust: In many cases the client is normally in a vulnerable situation therefore, trusts ensures that the client feels comfortable and is willing to discuss personal issues (Foster & Hawkins, 2005). (b) Respect: respect entails the recognition of worthiness, dignity and the uniqueness of a person irrespective of the personal attributes. In a therapeutic relationship there should be mutual respect. (c) Empathy: understanding and resonating with the clients needs are components of empathy. According to Roth, Hill and Pilling (2009) empathy entails maintaining appropriate professional response in the cause of the therapeutic engagement. (D) Power: in a therapeutic relationship, the relationship is of unequal power. The practitioner has more authority, influence and specialised knowledge which puts him/her at upper hand to dictate the processes the client to undergo, though in a respectful manner (Foster & Hawkins, 2005). Question 1 (B) Therapeutic relationships might rupture due to: Abuse of power- In a therapeutic relationship, the practitioner has more power over the client. Abuse of the power means that the practitioner does not respect the intrinsic balance in the relationship (Horvath, 2002). This may make the client feel not respected and a relationship can rupture. Lack of psychotherapeutic relationship- a therapeutic relationship entails a structured psychosocial and interpersonal intervention that influences the behaviour, mood and emotional reactions. Psychotherapeutic relationship should be aimed at boosting the confidence of the client and making the client feel part of the intervention (Horvath and Bedi, 2002). Failure to maintain the relationship will lead to possible rupture. Failure to exercise professional intimacy- Access to information and the ethical code of conduct is important in maintaining a therapeutic relationship. This is dictated by operating with professional boundaries (Safran, 2000). If a boundary is closed, it means that a care giver is misusing power; client will feel disrespected and can abort the relationship. Poor communication strategies- In a therapeutic relationship, a practitioner needs to use effective strategy to communicate to clients and also use interpersonal skills. These bring the client close to the practitioner by establishing a ethical relationship and thus the client feels obligated to respond to the questions raised (Safran, 2000). Failure to use good communication skills will result to mistrust and the relationship can break. Strategies to repair rupture According to Safran (2003), ruptures can be repaired through: Employ proper communication strategies Exercise professional intimacy Try to understand the preferences of the client and understand personal boundaries that need to be safeguarded. Maintain the intrinsic power balance in the relationship. Question 1 (C) The relationship between Mark and I ruptured when Mark I questioned about the past life of bullying and how it affected his future life. The relationship continued to rupture by not adhering to time schedule and later he did not want to discuss his emotional issues. According to Muran and Safran (2002) rupture can occur due to contribution of both parties involved in the therapeutic relationship. Ruptures arise as emotional disconnections which end up creating a negative shift and can gradually break the relationship (Hupcey, Penrod, Morse & Mitcham, 2001). The relationship between Mark and I ruptured through a withdrawal process in which Mark became disinterested. The reason behind the rupture can be attributed to: Poor communication strategy Misunderstanding in the part of the client (Mark). Good communication skills are supposed to ensure that the client has amble time and is given enough time to explain himself/herself. The good communication skills are also aimed at ensuring that the practitioner listens carefully to the client in order to understand and avoid demeaning the feelings of the client (Agnew, Haeper, Shapiro & Barkham, 1994). In this case, Mark was not given amble time to reflect on the issue of bullying. I suppose that he ought to have been allowed to explain himself without having to ask him to relate the bullying with his current time. Proper communication strategies should foster understanding and dispel mistrust between the client and the health care giver. As noted by (Muran & Safran, 2002) in a therapeutic relationship, the caregiver has more power and responsibility and thus in a respectful manner guides the relationship. This means that the communication used should be sensitive by considering the preferences of the client and encouraging the client to advocate on his/her behalf. This makes the client to be part of the communication and ensures that the client does not feel his/her private life being intruded. In the case of Mark, directly inquiring about the bullying consequences on personal life could have led him to think that his preferences were not being considered, thus the misunderstanding. Repairing the relationship The therapeutic relationship can be repaired by building confidence in Mark. This can be done through communication strategies that will entice him to feel as part of the solution. The counsellor should recognise that there is a cause behind attitude and behaviour of Mark (Horvath and Bedi, 2002). By exploring the clients behaviour and sudden change of attitude will help the practitioner in understanding the right communication to use. Question 2 The effectiveness of counselling depends on many factors. According to Bernes (2005) the effectiveness of counselling is relatively unambiguous as there is no specific counselling factor that that has overall effect in offering better results. I believe that the first hand experience in a problem that a client is facing can play a role in achieving effective counselling. Personal characteristics play crucial role in the counselling process. According to Watson and Bedard (2006) human nature best understands situations by learning from experience which makes them understand practical strategies to cope with the problem. Having gone through a problem, the counsellor is in a position to understand possible attitudes that may be affecting the person and can figure out the effective means to apply for the counselling session. In addition, counsellors who have gone through a problem are in position to prescribe practical remedies unlike those who are acting purely on theoretical knowledge only. For instance, empathy is an important skill in counselling. It entails understanding the perspective of another person and putting oneself in the person’s position. This helps in striking a balance between the client and counsellor and makes it possible to reason out together. In understanding another person’s predicament, first hand experience in such a problem gives an advantage and thus such counsellor will be in a better position to carry out an effective counselling. King et al (2000) found that effective counselling is premised on counsellors exhibiting personal characteristics in the following: Ability to establish friendships: Deep friendships are based on shared experiences and thus a counsellor who has had a similar experience will be able to build a faster and deep relationship. Empathy, warmth and genuiness: Genuiness in counselling plays a role in ensuring that a lasting therapeutic relationship has been established. As noted by Safran and Muran (2002) empathy stems from understanding the other persons perspective. Genuiness is an important component of empathy. People who have an experience in a given problem are in better position to understand the magnitude of the matter and hence will be more empathetic and genuine in counselling process. Despite of the perception that experience plays a role in effective counselling, there are many other components of counselling that if not applied appropriately, effective counselling will not be achieved. Therefore, a counsellor doe not have to be experienced in a problem for the effectiveness to be achieved. Many counsellors and fresh graduates who never had a social or psychological problem similar to that of client have been found to carry out effective counselling (Bernes, 2005). Effective counselling can be achieved if the counsellors have interpersonal skills. The interpersonal skills help in understanding the problem at hand and is used in devising strategies that will address the problem conclusively. Examples of interpersonal skills include communication skills and the ability to articulate the problem. In addition, effective counselling will take place based on the ability of the counsellor’s skills in building and maintaining health therapeutic relationships (McGilton et al, 2003). It is thus worth noting that experience on a problem is a very small aspect of counselling, unless these other components are integrated in the counselling process effectiveness will not be achieved. Professional intimacy is a counselling component that can determine the outcome of counselling. Professional intimacy helps a counsellor interact with the client in a manner that personal dignity is maintained. Professional intimacy in a counselling sessions helps in building trust and it is key to establishment of a strong therapeutic relationship that is necessary for successful counselling. Researches have shown that good relationship in counselling are important in ensuring that all counselling sessions have been completed (College of Ontario, 1999). Competency in counselling requires the broad knowledge in the given field of counselling, understanding of models required for the therapy, the philosophical principles that underpin the therapeutic model, and framework of the ethical considerations. These aspects coupled with ability to apply the broad knowledge in a therapeutic context which will lead to successful intervention determine how effective counselling will be (Bentler, 2000). Effective counselling is thus depended on integrating knowledge and skill to achieve an untended result by bearing in mind that counselling deals with personal issues. Counselling is an issue of dealing with personal issues; therefore the attitude the counsellor adopts shapes the process of counselling. The attitudes have a great bearing on determining the progress of counselling and its eventual results. If the attitudes are positive the counselling will likely yield positive results. This negates the perception that experience in the problem is crucial for effective counselling. It is thus true that counselling depends on professionalism. References Agnew, R. M., Harper, H., Shapiro, D.A., and Barkham, M. (1994). Resolving a challenge to the therapeutic relationship: A single case study. British Journal of Medical Psychology, 67(1), pp.155-170. Bentler, L. (2000). David and Goliath: When empirical and clinical standards of practice meet. American Psychologist, 55, pp.997-1009. Bernes, K. (2005). The Elements of Effective Counselling. Alberta, Canada: University of Lethbridge College of Nurses of Ontario. (1999). Professional Misconduct document. Toronto. Foster, T. and Hawkins, J. (2005). Nurse-patient relationship. The therapeutic relationship: Dead or merely impeded by technology? British Journal of Nursing, 14(13), 698-702. Horvath A. O, Bedi R. P. (2002). Psychotherapy Relationships That Work. New York: Oxford. Hupcey, J.E., Penrod, J., Morse, J.M. and Mitcham, C. (2001). An exploration and advancement of the concept of trust. Journal of Advanced Nursing, 36(2), pp.282-293. King, M., Sibbald, B., Ward, E., Bower, P., Lloyd, M., Gabbay, M. and Byford, S. (2000). Randomised controlled trial of non-directive counselling, cognitive- behaviour therapy and usual general practitioner care in the management of depression as well as mixed anxiety and depression in primary care. Health Technology Assessment 4, (19). McGilton, K.S., O’Brien-Pallas, L.L., Darlington, G., Evans, M., Wynn, F. & Pringle, D.M. (2003). Effects of a relationship-enhancing program of care on outcomes. Journal of Nursing Scholarship, 35(2), pp.151-156. Muran, J.C., and Safran, J.D. (2002). A Relational Approach to Psychotherapy: Resolving Ruptures in the Therapeutic Alliance. New York: Wiley. Roth, A. D., Hill A, and Pilling, S. (2009). The competences required to deliver effective Humanistic Psychological Therapies. Available at. http://www.ucl.ac.uk/clinicalpsychology/CORE/humanistic_framework.htm Safran, J. and Muran, J. (2000). Negotiating the Therapeutic Alliance: A Relational Treatment Guide. New York: Guilford Publications. Safran, J. (2003). Repairing rupture. New York: New School for Social Research. Watson, J. C., and Bedard, D. L. (2006). Clients’ emotional processing in psychotherapy: A comparison between cognitive-behavioural and process- experiential therapies. Journal of Counselling and Clinical Psychology, 74(1), pp.152-59. Read More

Poor communication strategies- In a therapeutic relationship, a practitioner needs to use effective strategy to communicate to clients and also use interpersonal skills. These bring the client close to the practitioner by establishing a ethical relationship and thus the client feels obligated to respond to the questions raised (Safran, 2000). Failure to use good communication skills will result to mistrust and the relationship can break. Strategies to repair rupture According to Safran (2003), ruptures can be repaired through: Employ proper communication strategies Exercise professional intimacy Try to understand the preferences of the client and understand personal boundaries that need to be safeguarded.

Maintain the intrinsic power balance in the relationship. Question 1 (C) The relationship between Mark and I ruptured when Mark I questioned about the past life of bullying and how it affected his future life. The relationship continued to rupture by not adhering to time schedule and later he did not want to discuss his emotional issues. According to Muran and Safran (2002) rupture can occur due to contribution of both parties involved in the therapeutic relationship. Ruptures arise as emotional disconnections which end up creating a negative shift and can gradually break the relationship (Hupcey, Penrod, Morse & Mitcham, 2001).

The relationship between Mark and I ruptured through a withdrawal process in which Mark became disinterested. The reason behind the rupture can be attributed to: Poor communication strategy Misunderstanding in the part of the client (Mark). Good communication skills are supposed to ensure that the client has amble time and is given enough time to explain himself/herself. The good communication skills are also aimed at ensuring that the practitioner listens carefully to the client in order to understand and avoid demeaning the feelings of the client (Agnew, Haeper, Shapiro & Barkham, 1994).

In this case, Mark was not given amble time to reflect on the issue of bullying. I suppose that he ought to have been allowed to explain himself without having to ask him to relate the bullying with his current time. Proper communication strategies should foster understanding and dispel mistrust between the client and the health care giver. As noted by (Muran & Safran, 2002) in a therapeutic relationship, the caregiver has more power and responsibility and thus in a respectful manner guides the relationship.

This means that the communication used should be sensitive by considering the preferences of the client and encouraging the client to advocate on his/her behalf. This makes the client to be part of the communication and ensures that the client does not feel his/her private life being intruded. In the case of Mark, directly inquiring about the bullying consequences on personal life could have led him to think that his preferences were not being considered, thus the misunderstanding. Repairing the relationship The therapeutic relationship can be repaired by building confidence in Mark.

This can be done through communication strategies that will entice him to feel as part of the solution. The counsellor should recognise that there is a cause behind attitude and behaviour of Mark (Horvath and Bedi, 2002). By exploring the clients behaviour and sudden change of attitude will help the practitioner in understanding the right communication to use. Question 2 The effectiveness of counselling depends on many factors.

According to Bernes (2005) the effectiveness of counselling is relatively unambiguous as there is no specific counselling factor that that has overall effect in offering better results. I believe that the first hand experience in a problem that a client is facing can play a role in achieving effective counselling. Personal characteristics play crucial role in the counselling process.

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